Neonatal mortality of low-birth-weight infants in Bangladesh

Objective To ascertain the role of low birth weight (LBW) in neonatal morta lity in a periurban setting in Bangladesh. Methods LBW neonates were recruited prospectively and followed up at one mo nth of age. The cohort of neonates were recruited after delivery in a hospi tal in Dhaka, Bangladesh, and 776 were successfully followed up either at h ome or, in the event of early death, in hospital. Findings The neonatal mortality rate (NMR) for these infants was 133 per 10 00 live births (95% confidence interval: 110-159). The corresponding NM Rs (and confidence intervals) for early and late neonates were 112 (91-136) an d 21 (12-33) per thousand live births, respectively. The NMR for infants bo rn after fewer than 32 weeks of gestation was 769 (563-910); and was 780 (6 40-885) for infants whose birth weights were under 1500g, Eighty-four per c ent of neonatal deaths occurred in the first seven days; half within 48 hou rs. Preterm delivery was implicated in three-quarters of neonatal deaths, b ut was associated with only one-third of LBW neonates. Conclusion Policy-relevant findings were: that LBW approximately doubles th e NMR in a periurban setting in Bangladesh; that neonatal mortality lends t o occur early, and that preterm delivery is the most important contributor to the NMR, The group of infants most likely to benefit from improvements i n low-cost essential care for the newborn accounted for almost 61% of neona tal mortalities in the cohort.